RESUMO
Introducción y objetivos: La artroplastia total de cadera (THA) es un procedimiento traumatológico cada vez más común, que comporta dolor postoperatorio de moderado a severo. El bloqueo del grupo de nervios pericapsulares (PENG) es un bloqueo reciente que parece aportar analgesia adecuada sin bloqueo motor significativo. El objeto de este estudio es comparar retrospectivamente la eficacia analgésica y la seguridad del bloqueo PENG y la analgesia epidural, en pacientes sometidos a THA. Material y métodos: Se trata de un estudio retrospectivo observacional durante un periodo de un año de los pacientes sometidos a THA primaria, utilizando analgesia epidural o bloqueo PENG ecoguiado con inyección única. Los datos relativos a las características demográficas, técnicas quirúrgicas y anestésicas, puntuaciones de dolor, consumo de opioides, complicaciones y tiempo hasta el alta hospitalaria se recopilaron de los registros institucionales, comparándose entre los dos grupos (analgesia epidural vs. bloqueo PENG). Resultados: No se encontraron diferencias significativas en cuanto a las puntuaciones de dolor, el consumo de opioides y el tiempo medio hasta el alta hospitalaria entre los dos grupos. Las puntuaciones de dolor en reposo (1,2 epidural vs. 1,67 PENG) o con movimiento (3,95 epidural vs. 3,72 PENG) fueron similares entre ambos grupos. El número total de complicaciones fue superior en el grupo de analgesia epidural (50% epidural vs. 5% PENG). Se reportó parestesia en ambos grupos. Solo se reportaron bloqueo motor, sedación, náuseas y complicaciones relacionadas con el catéter en el grupo de analgesia epidural. Conclusiones: El bloqueo PENG parece ser equivalente a la analgesia epidural en cuanto a calidad de la analgesia postoperatoria para los pacientes sometidos a THA primaria, lo cual respalda el uso rutinario de este bloqueo en estos pacientes. La baja tasa de complicaciones reportadas limita las conclusiones sobre esta cuestión.(AU)
Introduction and objectives: Total hip arthroplasty (THA) is an increasingly common orthopedic pro-cedure, with moderate to severe postoperative pain. Pericapsular nerve group (PENG) block is a recent block that seems to provide adequate analgesia without significant motor blockade. The aim of this study is to retrospectively compare the analgesic efficacy and safety of PENG block with those of epidural analgesia, in patients undergoing THA. Material and methods: This is a retrospective observational study of patients who underwent primary THA, submitted to epidural analgesia or single-shot ultrasound-guided PENG block, during a one-year period. Data regarding demographic characteristics, surgery and anesthesia techniques, pain scores, opioid consumption, complications and time to hospital discharge were retrieved from institutional records and compared between the 2 groups (epidural analgesia vs PENG block). Results: No significant difference was found regarding pain scores, opioid consumption, and mean time to hospital discharge between the 2 groups. Pain scores at rest (1.20 epidural vs 1.67 PENG) or with movement (3.95 epidural vs 3.72 PENG) were similar between groups. Total number of complications was higher in the epidural analgesia group (50% epidural vs 5% PENG). Paresthesia was reported in both groups. Motor block, sedation, nausea and catheter-related complications were only found in the epidural analgesia group. Conclusions: PENG block seems to be equivalent to epidural analgesia regarding quality of postop-erative analgesia for patients subject to primary THA, supporting routine use of this block in these patients. The low rate of reported complications limits conclusions on this topic.(AU)
Assuntos
Humanos , Feminino , Analgesia Epidural , Artroplastia de Quadril , Dor Pós-Operatória , Fraturas do Quadril , Estudos Retrospectivos , AnestesiologiaRESUMO
INTRODUCTION AND OBJECTIVES: Total hip arthroplasty (THA) is an increasingly common orthopaedic procedure, with moderate to severe postoperative pain. Pericapsular nerve group (PENG) block is a recent block that seems to provide adequate analgesia without significant motor blockade. The aim of this study is to retrospectively compare the analgesic efficacy and safety of PENG block with those of epidural analgesia, in patients undergoing THA. MATERIAL AND METHODS: This is a retrospective observational study of patients who underwent primary THA, submitted to epidural analgesia or single-shot ultrasound-guided PENG block, during a one-year period. Data regarding demographic characteristics, surgery and anaesthesia techniques, pain scores, opioid consumption, complications and time to hospital discharge were retrieved from institutional records and compared between the 2 groups (epidural analgesia vs PENG block). RESULTS: No significant difference was found regarding pain scores, opioid consumption, and mean time to hospital discharge between the 2 groups. Pain scores at rest (1.20 epidural vs 1.67 PENG) or with movement (3.95 epidural vs 3.72 PENG) were similar between groups. Total number of complications was higher in the epidural analgesia group (50 % epidural vs 5% PENG). Paresthesia was reported in both groups. Motor block, sedation, nausea and catheter-related complications were only found in the epidural analgesia group. CONCLUSIONS: PENG block seems to be equivalent to epidural analgesia regarding quality of postoperative analgesia for patients subject to primary THA, supporting routine use of this block in these patients. The low rate of reported complications limits conclusions on this topic.
